Objective To investigate the differences in pathological changes and immune responses of human airway organoids at different stages of differentiation following respiratory syncytial virus(RSV)infection.Methods Models of human fetal lung organoids(FLO)and induced airway organoids(iAO)were established to simulate immature and mature airway epithelium.Immunofluorescence staining,electron microscopy,and quantitative polymerase chain reaction(Q-PCR)were used to confirm the successful construction of the lung organoid models.Human lung organoids were infected with RSV,and samples were collected at 6 and 48 hours post-infection.The immune characteristics of immature and mature RSV-infected organoids were assessed using immunofluorescence staining,droplet digital PCR(DDPCR),and Q-PCR.Results We successfully generated FLO expressing both the progenitor markers sex determining region Y-box transcription factor 2(SOX2)and sex determining region Y-box transcription factor 9(SOX9),as well as iAO containing basal cells,ciliated cells,club cells,and goblet cells.In addition,organoid models of RSV infection were established.DDPCR results showed that,at the initial stage of RSV infection,the viral load in iAO was significantly higher than that in FLO(P＜0.001).However,at 48 hours post-infection,the viral load in iAO was lower than that in FLO(P＜0.05).Q-PCR results indicated that the expression of RSV infection receptor genes,including epidermal growth factor receptor(EGFR),insulin-like growth factor 1 receptor(IGF1R),and nucleolin(NCL),was significantly higher in iAO compared to that in FLO(P＜0.001).RSV infection led to an increase in the expression levels of immune factors,including interleukin 6(ILL-6),interleukin 8(CXCL8),interferon α(IFN-α),granulocyte colony-stimulating factor(G-CSF),granulocyte-macrophage colony-stimulating factor(GM-CSF),and tumor necrosis factor α (TNF-α),in iAO compared to those in FLO,and the differences were statistically significant(P＜0.05).Conclusion The expression of RSV infection receptor proteins increases with airway maturation,and mature airway epithelial cells exhibit a stronger immune response than immature ones do,effectively inhibiting RSV replication.

The intervention and prevention of perioperative hypothermia is not only reflected in the technical level, but also reveals the important role of humanistic care in the whole intervention work. If perioperative patients have hypothermia, it is likely to cause a series of complications such as postoperative shivering, which seriously threatens the life safety of patients. Prevention and intervention was based on a comprehensive understanding of the causes and hazards of hypothermia, especially the impact on the lives of the elderly. Effective supervision was implemented in the whole process of operation, such as dynamic monitoring of vital signs including body temperature, followed by room temperature regulation, body temperature protection and preoperative and postoperative psychological nursing. At this time, the sense of responsibility, good humanistic care of medical staff are of positive significance to effectively prevent and reduce the probability of perioperative hypothermia and accelerate the postoperative rehabilitation of patients.

Background and aim:Few studies have reported hepatitis B surface antigen(HBsAg)kinetics after nucleos(t)ide analog(NA)discontinuation in patients with noncirrhotic chronic hepatitis B(CHB).The study specifically investigated long-term HBsAg kinetics after NA discontinuation. Methods:Between January 2014 to January 2024,this study prospectively enrolled 106 outpatients with noncirrhotic CHB who met the discontinuation criteria after NA consolidation treatment.Demographic,clinical,and laboratory data were collected and analyzed after NA discontinuation. Results:Ninety-six patients who finished 5 years of follow-up were included.HBsAg remained unde-tectable in 29 patients with end of treatment(EOT)HBsAg negativity.Among 67 patients with EOT HBsAg positivity,HBsAg seroclearance occurred in 12(17.9％)patients with an estimated annual inci-dence of HBsAg seroclearance of 3.6％.Patients with EOT HBsAg levels of ≤1000 IU/mL had a higher HBsAg seroclearance rate than those with EOT HBsAg levels of＞1000 IU/mL(33.3％vs.5.4％).The pro-portion of patients with HBsAg ≤1000 IU/mL increased during follow-up.Logistic regression analysis indicated that the EOT HBsAg level was an independent factor for HBsAg seroclearance and an HBsAg level decline exceeding 1 log10 IU/mL.The optimal EOT HBsAg cutoff for both HBsAg seroclearance and an HBsAg level decline exceeding 1 log10 IU/mL was 359 IU/mL. Conclusions:Patients with EOT HBsAg negativity experienced no relapse and maintained HBsAg sero-clearance during 5 years of follow-up after NA discontinuation.A higher HBsAg seroclearance rate can be obtained in patients with EOT HBsAg levels of ≤1000 IU/mL during 5 years of follow-up after NA discontinuation.Close monitoring and proper NA retreatment are recommended to guarantee the safety of NA discontinuation.

Objective:To analyze the blood differential metabolites of patients with intrahepatic cholestasis (IHC) by liquid chromatography-mass spectrometry metabolomics technology so as to find potential metabolic target.Method:Serum samples were collected from thirty patients with intrahepatic cholestasis and thirty healthy individuals after metabolomics analysis. The differential metabolites were initially screened based on the multiple differences and significance. KEGG enrichment analysis was performed on the differential metabolites to determine the candidate targets. The potential clinical application value of these characteristic metabolites was analyzed using the receiver operating characteristic curve.Result:A total of thirty patients with intrahepatic cholestasis and thirty healthy adults were included. The age difference between the two groups was not statistically significant ( P>0.05). The clinical condition was consistent with the statistically significant differences in liver biochemical indicators, blood routine, coagulation, and inflammatory indicators between the two groups ( P<0.05). Furthermore, a blood metabolomics screening analysis revealed 99 differentially expressed metabolites associated with intrahepatic cholestasis. Of these, 15 showed statistically significant differences. Glucose, lipid, and energy metabolisms were the various primary types of differential metabolites involved. The receiver operating characteristic curve>0.9 included the following twelve kinds of metabolites: 1H-indole-3-carboxaldehyde, 6-hydroxy-1H-indole-3-acetamide, phenylalanyl tryptophan, 1-methylguanosine, 2-ethoxy-5-methylpyrazine, p-hydroxybenzaldehyde, 5-(2-chlorophenyl)-3,4-dihydro-2H-pyrrole, methylthioadenosine, alanylisoleucine, anabsinthin, N-acetyl-DL-histidine monohydrate, N-methylnicotinamide, and others. The fifteen metabolites that were previously identified and calculated according to the differential quantitative value of the metabolite corresponding ratio exhibited fold-changes in the upregulated and downregulated potential biomarkers (phenylalanine tryptophan, phenylalanine, 5'-methylthioadenosine, anabsinthin, and N-methylnicotinamide) in combination with the area under the receiver operating characteristic curve>0.9. Conclusion:Phenylalanyl tryptophan, phenylalanylalanine, 5'-methylthioadenosine, anabsinthin, and N-methylnicotinamide may serve as potential metabolic markers to distinguish patients with cholestasis from healthy controls. N-methylnicotinamide, among them, is of great importance as a potential marker.

Objective:To analyze the status of respiratory pathogen detection and the clinical features in children with Mycoplasma pneumoniae pneumonia (MPP). Methods:A prospective, multicenter study was conducted to collect clinical data, including medical history, laboratory examinations and multiplex PCR tests of children diagnosed with MPP from 4 hospitals in China between November 15 th and December 20 th, 2023. The multiplex PCR results and clinical characteristics of MPP children in different regions were analyzed. The children were divided into severe and mild groups according to the severity of the disease. Patients in the severe group were further divided into Mycoplasma pneumoniae (MP) alone and Multi-pathogen co-detection groups based on whether other pathogens were detected besides MP, to analyze the influence of respiratory pathogen co-detection rate on the severity of the disease. Mann-Whitney rank sum test and Chi-square test were used to compare data between independent groups. Results:A total of 298 children, 136 males and 162 females, were enrolled in this study, including 204 children in the severe group with an onset age of 7.0 (6.0, 8.0) years, and 94 children in the mild group with an onset age of 6.5 (4.0, 7.8) years. The level of C-reactive protein, D-dimer, lactic dehydrogenase (LDH) were significantly higher (10.0 (5.0, 18.0) vs. 5.0 (5.0, 7.5) mg/L, 0.6 (0.4, 1.1) vs. 0.5 (0.3, 0.6) mg/L, 337 (286, 431) vs. 314 (271, 393) U/L, Z=2.02, 2.50, 3.05, all P<0.05), and the length of hospitalization was significantly longer in the severe group compared with those in mild group (6.0 (6.0, 7.0) vs. 5.0 (4.0, 6.0) d, Z=4.37, P<0.05). The time from onset to admission in severe MPP children was significantly shorter than that in mild MPP children (6.0 (5.0, 9.5) vs. 9.0 (7.0, 13.0) d, Z=2.23, P=0.026). All patients completed the multiplex PCR test, with 142 cases (47.7%) MPP children detected with 21 pathogens including adenovirus 25 cases (8.4%), human coronavirus 23 cases (7.7%), rhinovirus 21 cases (7.0%), Streptococcus pneumoniae 21 cases (7.0%), influenza A virus 18 cases (6.0%). The pathogens with the highest detection rates in Tianjin, Shanghai, Wenzhou and Chengdu were Staphylococcus aureus at 10.7% (8/75), adenovirus at 13.0% (10/77), adenovirus at 15.3% (9/59), and both rhinovirus and Haemophilus influenzae at 11.5% (10/87) each. The multi-pathogen co-detection rate in severe MPP children was significantly higher than that in mild MPP group (52.9% (108/204) vs. 36.2% (34/94), χ2=10.62, P=0.005). Among severe MPP children, there are 89 cases in the multi-pathogen co-detection group and 73 cases in the simple MPP group. The levels of LDH, D-dimer and neutrophil counts in the multi-pathogen co-detection group were significantly higher than those in the simple MPP group (348 (284, 422) vs. 307 (270, 358) U/L, 0.8 (0.5, 1.5) vs. 0.6 (0.4, 1.0) mg/L, 4.99 (3.66, 6.89)×10 9vs. 4.06 (2.91, 5.65)×10 9/L, Z=5.17, 4.99, 6.11, all P<0.05). Conclusions:The co-detection rate of respiratory pathogens, LDH and D-dimer in children with severe MPP were higher than those with mild MPP. Among severe MPP children the stress response of children in co-detection group was more serious than that of children with simple MPP.

Objective To investigate the regulatory effect of miRNA-933 on the apoptosis and proliferation of human hepatic stellate cell line LX-2 and its mechanism.Methods Firstly,with human liver tissue for research,gene microarray technology was used to detect the differentially expressed genes in liver tissue between liver cirrhosis/chronic hepatitis B tissue and normal liver tissue,among which the significantly differentially expressed miRNAs were identified,and thus miRNA-933 was determined as the research object.Then,with the human hepatic stellate cell line LX-2 for research,miRNA-933 mimic and inhibitor(miRNA-933 siRNA)were used to construct the LX-2 models of overexpression and knockdown,and the cells transfected with mimic-NC(overexpression)or siRNA-NC(knockdown)were established as the negative control group.Quantitative real-time PCR and Western blot were used to measure the expression levels of miRNA-933 and activation biomarkers;techniques such as cell proliferation assay and flow cytometry were used to investigate the effect and mechanism of miRNA-933 on cell apoptosis,proliferation,and activation.The independent-samples t test was used for comparison of continuous data between two groups;a one-way analysis of variance was used for comparison between multiple groups,and Bonferroni correction was also performed.Results A total of 18 significantly differentially expressed miRNAs were obtained based on the results of gene microarray,among which miRNA-933 was significantly downregulated(P<0.05).After LX-2 cells were transfected with miRNA-933 mimic or siRNA,compared with the negative control group,miRNA-933 siRNA significantly downregulated the expression of miRNA-933(P=0.000 7),while miRNA-933 mimic significantly upregulated the expression of miRNA-933(P=0.000 3).Western blot and quantitative real-time PCR showed that miRNA-933 siRNA significantly upregulated the expression of collagen Ⅰ and α-SMA(P<0.001),while miRNA-933 mimic significantly inhibited the expression of collagen Ⅰ and α-SMA(P<0.05).Flow cytometry showed that compared with the negative control group,miRNA-933 siRNA significantly downregulated the apoptosis rate of LX-2 cells(P=0.031 9),and miRNA-933 mimic significantly upregulated the apoptosis rate of LX-2 cells(P=0.005 5).Western blot showed that compared with the negative control group,miRNA-933 siRNA could inhibit the expression of Caspase-3(P=0.006 7)and poly(ADP-ribose)polymerase-1(PARP-1)(P=0.003 0)and upregulate the expression of B-cell lymphoma-2(Bcl-2)in LX-2 cells(P=0.002 0),while miRNA-933 mimic could significantly upregulate the expression of Caspase-3(P=0.011 8)and PARP-1(P=0.049 5)and downregulated the expression of Bcl-2(P=0.002 1).Cell proliferation assay showed that compared with the negative control group,miRNA-933 siRNA could promote the proliferation of LX-2 cells(P=0.011 5),while on the contrary,miRNA-933 mimic could inhibit the proliferation of LX-2 cells(P=0.001 2).Western blot and quantitative real-time PCR showed that miRNA-933 siRNA significantly inhibited the expression of Kruppel-like factor 6(KLF6)and downregulated the expression of activating transcription factor 4(ATF4),activating transcription factor 3(ATF3),and C/EBP homologous protein(CHOP),while miRNA-933 mimic promoted the expression of the above proteins(all P<0.05).Conclusion This study shows that miRNA-933 may promote cell apoptosis and inhibit cell activation and proliferation by promoting the activation of the KLF6/ATF4/ATF3/CHOP/Bcl-2 signal axis in LX-2 cells.

Objective:To analyze the clinical phenotypic characteristics and therapeutic effect of cutaneous anthrax patients in Ningxia Hui Autonomous Region (referred to as Ningxia).Methods:A retrospective analysis was conducted on the medical records of 76 confirmed patients with cutaneous anthrax in three prefecture level hospitals in Ningxia from 2017 to 2022. According to the length of hospital treatment, the patients were divided into a disease course ≥7 d group ( n = 54) and a disease course < 7 d group ( n = 22), and the clinical phenotypic characteristics (including patients' general condition, clinical symptoms, and laboratory tests) and therapeutic effects (the effect of hormone use and the choice of antibiotics) of the two groups were analyzed by methods such as χ 2 test. Results:Among 76 patients with cutaneous anthrax, males accounted for 81.6% (62/76) and females accounted for 18.4% (14/76), with a statistically significant difference in gender composition ratio (χ 2 = 5.71, P = 0.017). Among the 76 patients, 73 caces (96.1%) achieved clinical cure. There was no statistically significant differences between the groups in clinical characteristics such as temperature, pain, pruritus, edema, and site of onset ( P > 0.05). There were no statistically significant differences between groups in laboratory tests such as blood routine, liver function, hypersensitive C-reactive protein, secretion culture, PCR, etc. ( P > 0.05). There was a statistically significant difference in the distribution of edema resolution time between patients using hormone or not (χ 2 = 17.01, P = 0.002). There was no statistically significant difference in the distribution of disease course between different antibiotic treatment regimens when using hormone (χ 2 = 5.43, P = 0.143). There was a statistically significant difference in the distribution of disease course between different antibiotic treatment regimens when no using hormone (χ 2 = 108.46, P < 0.001). Conclusions:The majority of cutaneous anthrax patients in Ningxia from 2017 to 2022 are males. Early use of hormones can affect the duration of edema in patients. For patients who have not received hormone therapy, different treatment plans can affect the patient's course of disease.

Objective To explore the correlation of contrast-enhanced ultrasound(CEUS)parameters of adenomyoma before and after MR-guided focused ultrasound surgery(MRgFUS)with the therapeutic efficacy.Methods Uterine ultrasound and CEUS data of 26 patients with adenomyoma before and 24 h,1 and 6 months after MRgFUS,as well as MRI before and immediately after MRgFUS were retrospectively analyzed.The lesion volume shown on CEUS and MRI before MRgFUS,the non perfusion volume(NPV)of adenomyoma on MRI immediately after and CEUS 24 h after MRgFUS were compared.The ablation rate of lesions was calculated based on CEUS 24 h after MRgFUS.The focal blood flow score before,24 h after MRgFUS and the sum of the two,also the numerical rating scale(NRS)score before and 1,6 months after MRgFUS and the change rate were analyzed.The correlations of CEUS parameters with the efficacy of MRgFUS for treating adenomyoma were observed.Results No significant difference of lesion volume nor NPV on CEUS or MRI was found(both P＞0.05).The ablation rate of lesions 24 h after treatment was(58.11±24.92)%.The focal blood flow score before,24 h after MRgFUS and the sum of the two was 2.00(2.00,2.00),1.00(1.00,1.00)and 3.50(3.00,3.50),respectively,with significant difference between before and 24 h after MRgFUS(Z=-4.463,P＜0.001).NRS score was 5.00(4.00,6.00),3.00(2.00,4.00)and 2.00(1.00,3.00)before treatment,1 and 6 months after treatment,respectively,with significant differences at different time points(all P＜0.01).The change rate of NRS score 1 and 6 months after treatment was 35.42%(23.75%,50.00%)and 60.00%(50.00%,77.08%),respectively.The lesion blood flow score before and 24 h after MRgFUS and the sum of the two were all negatively correlated with ablation rate(rs=-0.552,-0.820,-0.745),while positively correlated with NRS scores 6 months after treatment(rs=0.513,0.552,0.496)but negatively correlated with the change rate of NRS scores 6 months after treatment(rs=-0.525,-0.479,-0.531).The ablation rate 24 h after treatment was negatively correlated with NRS scores(rs=-0.462)while positively correlated with the change rate of NRS scores 6 months after treatment(rs=0.500).Conclusion CEUS parameters before and after treatment were correlated with the therapeutic efficacy of MRgFUS for treating adenomyoma.

Objective To investigate the effects of microgravity environment on hibernating myoblasts.Methods Hibernating myoblasts were cultured under real and simulated microgravity conditions for 10 days.RNA-seq analysis and immunofluorescence are used to analysis the impact of microgravity environment on cell growth and gene expression of myoblasts.Results Under the microgravity conditions,genes associated with proliferation were upregulated.Under simulated microgravity,there were more and higher proportion of Ki67 positive cells compared to normal gravity conditions.Conclusion The microgravity environment promotes the proliferation of hibernating myoblasts.

Objective To analyze and compare the changes in local functional activity of the brain under different recovery times after a 90-day,-6° head down bed rest(HDBR)experiment,clarify the mechanism of brain function remodeling during gravity adaptation,and provide imaging basis and guidance for the model construction and health assessment.Methods 36 healthy male volunteers underwent resting-state functional magnetic resonance imaging(rs-fMRI)scans before HDBR(PRE),3 days after 90-day HDBR(R+3),and 26-28 days after 90-day HDBR(R+26-28),and calculated regional homogeneity(ReHo)and low-frequency amplitude(ALFF)and perform statistical analysis between different time points.Results Compared with PRE-status,ReHo value in the left inferior parietal gyrus and ALFF value in the right posterior cingulate gyrus decreased significantly in R+3 status,while ReHo value in the left calcarine,right lingual gyrus and ALFF value in the precuneus,left paracentral lobule,and right postcentral gyrus increased significantly.At R+26-28 status,more brain areas showed significant changes.Conclusion 90 days of long-term HDBR and subsequent recovery will lead to changes in the neural functional activities of the brain's default network,sensorimotor network and visual network,and obvious adaptive remodeling will occur after a longer period of gravity re-adaptation and recovery.